OBJECTIVE To study the clinical characteristics of traumatic hyphema and to discuss the place of medical and surgical treatment. METHODS A retrospective study of 40 patients hospitalized between 1991 and 1995 for traumatic hyphema was conducted. RESULTS The average age of patients was 16 years. There were 87.5% males. Sex ratio was 7.1. Dangerous games were responsible for injury in 40% of cases. 60% were grade 2 or less. With medical treatment, outcome was favorable in 67.5% of eyes with hyphema, often within 2 to 5 days. However, complications occurred in 35% of cases: secondary hemorrhage, ocular hypertony, blood staining of the cornea and posterior synechiae. Only 4 cases needed surgical treatment. 3 of them developed secondary hemorrhage after surgery. CONCLUSIONS Traumatic hyphema is a diagnostic and therapeutic emergency. More preventive efforts are needed especially in children. Outcome is generally good if medical treatment was quickly instituted. Surgical treatment must be reserved for cases with refractory persistant hypertony, because of the risk of secondary bleeding.